在急性老年病房出院后,最年长的成年人死亡率
1Geriatrics Department, Kaplan Medical Center, Affiliated With the Hebrew University of Jerusalem, Rehovot, Israel.
Gerontology & geriatric medicine
|May 30, 2023
概括
在医院出院后,确定老年人 (≥90岁) 死亡风险因素至关重要. 低白蛋白,高尿素和脆弱性预测生存率,指导干预措施以获得更好的出院后结果.
科学领域:
- 老年医学 老年医学
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 退院后的死亡率是最老年人群的一个重大问题.
- 识别特定的风险因素对于提高生存率至关重要.
研究的目的:
- 调查90岁及以上患者从急性老年病房出院后与死亡相关的风险因素.
- 为了确定短期 (1个月,1年) 和长期 (14年) 离院后生存的预测因素.
主要方法:
- 对448名90岁以上的老年病患进行了回顾性分析,这些患者从急性老年病房出院.
- 评估临床因素,并发症,功能状态和药物使用.
- 考克斯回归分析的应用,以确定死亡风险因素.
主要成果:
- 低血清白蛋白,高尿素和严重的功能依赖与1年内死亡率有关.
- 根据年龄调整的查尔森并发症指数,神经乱药物和脆弱性预测了1年的死亡率.
- 长期 (14年) 死亡率与并发症 (贫血,痴呆症),功能状态,神经乱药的使用,低白蛋白,高尿素和高维生素B12相关.
结论:
- 优化治疗急性疾病和在医院获得的并发症对于出院后的生存至关重要.
- 在住院期间预防功能衰退可能会提高最老的长期生存率.
- 对已识别的风险因素进行全面的评估和管理可以改善老年患者退院后的治疗结果.
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